ACTINOMYCOSIS. 
87 
are ligatured as exposed, the larger doubly ligatured and then cut thiough. 
In this way, and by free use of sponges or dossils of lint, the field of 
operation is kept clear, and the gland removed without dangerous 
bleeding. The wound is then cleansed with antiseptic fluids, dusted 
with iodoform, covered with jute or wood wool, and the edges brought 
together with sutures. In twenty-four to forty-eight hours the stitches 
are loosened, the dressings removed, the wound washed out, dusted 
with iodoform and tannin, and the whole treated as an open wound. 
Healing will be complete in three or four weeks. To allow the air free 
entrance to the wound surface, the flaps should be drawn back with a 
few stitches, and pledgets of wood-wool wadding inserted in the depths 
of the wound, so as to take up the secretions rapidly. The external 
skin should also be divided, to permit discharges to escape rapidly. 
The insertion of a drainage-tube may be required. If during the next 
few days portions of the wound appear damp, they should be diied with 
wadding, and powdered with a mixture of iodoform and tannin (1 3). 
Where a dry scab has formed, the wound is better left undisturbed. 
Dry scabs, firmly adherent to the underlying tissues, should under no 
circumstances be removed. 
(7) ACTINOMYCOSIS IN THE PAROTIDEAL REGION. 
Although actinomycosis of the paroticleal region is also occasionally 
seen in horses and swine, it is very much commoner in cattle. Ly 
proliferation of the connective tissue new growths are slowly formed in 
the subparotideal and retropharyngeal regions. These were formerly 
erroneously regarded and described as tumours. Their true cause is to 
be sought in local infection with the actinomyces fungus. 
The parasites are probably taken along with the food, and find 
entrance into the mucous membrane and deeper-lying tissues through 
wounds caused by the rough character of the food. The circumstance 
that herbivora most frequently suffer from the disease, supports the 
theory that infection results in this way. , Joline detected vegetable 
material invaded by actinomyces in the tonsils of swine ; Grawitz found 
portions of a head of corn in the lower jaw of a calf, which were 
surrounded by granulation tissue. Bang found the disease more widely 
distributed where much barley straw was given as food. Fischer describes 
a wound of the human tongue produced whilst chewing some barley; ray 
fungi were found in the abscess which resulted, and the portions of 
grain discharged were also covered with them. According to Immingei, 
epizootics of aphtha favour infection, for he found that after these 
actinomycosis broke out over large areas. Frick considers that the 
fungus is often carried by the fodder, in proof of which he relates the 
